BILL ANALYSIS Ó SB 914 Page 1 Date of Hearing: June 22, 2016 ASSEMBLY COMMITTEE ON INSURANCE Tom Daly, Chair SB 914 (Mendoza) - As Introduced January 26, 2016 SENATE VOTE: 36-0 SUBJECT: Workers' compensation: medical provider networks: independent medical reviews SUMMARY: Repeals outdated references to certain medical treatment guidelines. Specifically, this bill deletes several references to the American College of Occupational and Environmental Medicine's (ACOEM) treatment guidelines from the Labor Code. EXISTING LAW: 1)Establishes a comprehensive system to provide benefits, including medical treatment, to employees who are injured or suffer conditions that arise out of or in the course of employment. 2)Requires treatment to be evidence-based, as detailed in a Medical Treatment Utilization Schedule adopted and maintained by the Administrative Director (AD) of the Division of SB 914 Page 2 Workers' Compensation (DWC). 3)Required, subsequent to the 2004 workers' compensation reforms, that the ACOEM guidelines be utilized when making medical treatment decisions, until such time as the AD adopted alternative guidelines. 4)Continues to reference ACOEM despite the AD having adopted alternative guidelines. FISCAL EFFECT: Undetermined; the bill is keyed non-fiscal by Legislative Counsel. COMMENTS: 1)Purpose. According to the author, the DWC has suggested that the Labor Code be cleaned up to reflect the fact that the references to ACOEM are no longer accurate, and could potentially be confusing. The bill is the author's effort to accomplish this goal. 2)Background. In 2004, the Legislature passed SB 899 (Poochigian), Chapter 34, Statutes of 2004, which was a major reform of the California workers' compensation system. As a part of that reform, SB 899 required the DWC to create an evidence-based set of medical guidelines to ensure that injured workers were receiving consistent, appropriate treatment from physicians. In the intervening period, SB 899 required that physicians use the ACOEM guidelines, which are a set of widely-utilized evidence-based, peer reviewed medical guidelines that continue to be used in California's workers' compensation system and many other state workers' compensation systems. SB 914 Page 3 In 2009, the DWC promulgated the California-specific workers' compensation system medical treatment guidelines known as the MTUS. The MTUS utilized many of the chapters that make up ACOEM, but also referenced additional guidelines or developed independent guidance on medical treatment. As such, while ACOEM is still used as a part of the MTUS, it no longer operates as a stand-alone guideline, and the references to it in the Labor Code can be confusing and cause practitioners to fail to refer to the MTUS. REGISTERED SUPPORT / OPPOSITION: Support None received Opposition None received Analysis Prepared by:Mark Rakich / INS. / (916) 319-2086 SB 914 Page 4